Individual provider Active NPI

Antonio Dominguez Romero, MD

  • Gynecology Physician
  • San Juan, PR
National Provider Identifier
1487682340
Registry record updated Nov 8, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gynecology PhysicianTaxonomy code 207VG0400X
License
11771 Issued in PR
Practice address
1007 Ave Munoz Rivera
Edif Darlington of: L1
San Juan, PR 00925
Phone
(787) 600-7798
Fax
(787) 545-1134
NPI assigned
Jun 29, 2006
Last updated
Nov 8, 2016By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 8, 2016

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Gynecology Physician 207VG0400X 11771 PR Primary

Addresses

Primary practice location

1007 Ave Munoz Rivera
Edif Darlington of: L1
San Juan, PR 00925

Mailing address

83 Cervantes Apt 3B
Condado
San Juan, PR 00907
Phone (787) 600-7798

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PR
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20140925000922 PR Practitioner - Obstetrics/Gynecology 0345460366 Practice locations: San Juan, PR

Care Compare profile

Medicare Care Compare
Specialty
Obstetrics/Gynecology
Education
Other, 1991
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

1007 Ave Munoz Rivera
Suite 1
San Juan, PR 00925-2716
Phone (787) 600-7798

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Integrate Community Health System, Inc. Past Accepting new patients
Integrate Community Health System, Inc. Past Accepting new patients

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1151539200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1478563200000",
    "number": "1487682340",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "83 CERVANTES APT 3B",
            "address_2": "CONDADO",
            "city": "SAN JUAN",
            "state": "PR",
            "postal_code": "00907",
            "telephone_number": "787-600-7798",
            "fax_number": "787-545-1134"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1007 AVE MUNOZ RIVERA",
            "address_2": "EDIF DARLINGTON OF: L1",
            "city": "SAN JUAN",
            "state": "PR",
            "postal_code": "00925",
            "telephone_number": "787-600-7798",
            "fax_number": "787-545-1134"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DOMINGUEZ ROMERO",
        "first_name": "ANTONIO",
        "name_prefix": "Mr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-06-29",
        "last_updated": "2016-11-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207VG0400X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology, Gynecology",
            "state": "PR",
            "license": "11771",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Juan, PR

Sources for this page

Verify at the official NPI Registry.